Having Diabetes, Managing Cholesterol
Maintaining healthy cholesterol levels is something everybody should think
about. But people with diabetes need to give cholesterol management extra
consideration. Why? Because simply having diabetes can affect the balance
between the two types of cholesterol—HDL (the “good” kind) and LDL (the “bad”
kind). That balance is crucial for a healthy cardiovascular system.
Ideally, you want to have more HDL and less LDL cholesterol in your blood. The
LDL cholesterol is what causes fat to build up in the arteries. Too much of a
buildup makes the arteries rigid and not flexible. That’s where the term
“hardening of the arteries” comes from. Arteries need to be flexible to allow
blood to flow easily through them to the heart.
The HDL cholesterol, on the other hand, carries away some of the bad cholesterol
that’s been stored in the arteries. That’s why you want to have more of it, and
How does diabetes affect cholesterol?
Having diabetes, and especially having higher levels of blood sugar, is enough
to put you in a higher risk category for heart disease. Why?
- For people with diabetes, there’s a greater likelihood that LDL
cholesterol particles will stick to the arteries and damage their walls
- Blood sugar, which is often higher in people with diabetes, coats the LDL
particles and causes them to remain in the blood stream longer
- People with diabetes are more likely to have lower HDL levels. In other
words, there’s less of the good cholesterol to help remove the bad kind. And
people with diabetes also are more likely to have higher levels of another
type of fat, called triglycerides, in their blood.
New cholesterol guidelines may affect you
This summer, the National Heart, Lung, and Blood Association (NHLBI) revised its
cholesterol guidelines. For people who have diabetes or heart disease, or who
smoke and have high blood pressure, the NHLBI has lowered the target levels of
LDL from 100 mg/dL to 70.
What can you do to make sure your levels are in the healthy range?
Visit your doctor to have your cholesterol checked if you haven’t done so
lately. If your numbers are on target, then that’s good. If they’re not, talk
with your doctor and a nutritionist, dietitian or diabetes educator to see what
you can do to bring your numbers down. Diet, exercise, and medications play a
key role. Take a look at the tips we offer in the next section of this magazine
for some detailed suggestions about healthy cholesterol levels.
Taking care of cholesterol: one link in a large chain
Keeping your cholesterol in the healthy range is about so much more than simply
the numbers. It’s also about helping lower your risk of heart attack and stroke.
It’s about keeping your vascular system healthy, which in turn can help reduce
such complications as foot ulcers.
Each component of diabetes care is an important link in a chain, so it’s
important to do your best in all areas—healthy food, regular exercise, quitting
smoking, routine medical visits, strict blood sugar control. It’s all
And don’t forget to meet with your dietitian or diabetes educator at least once
a year, even when things are going well. Your diabetes status changes over time,
and it’s important to make adjustments along the way.
Diabetes Tips: Lowering Your Cholesterol Level
You have good intentions about keeping your cholesterol in the healthy range,
but where do you start? The members of your healthcare team can make
recommendations based on your specific situation, but the following tips are:
- Limit foods containing saturated fat and trans fats. Your dietitian can
help you create a plan that works well for you. It’s helpful to read food
labels, because they’ll tell you how much saturated fat you’re getting. But
trans fat quantities aren’t listed on the labels yet, and aren’t required to
be until 2006. To figure out whether there are trans fats in any given food,
look for the words “partially hydrogenated.” You’re likely to see these fats
in most crackers, chips, cookies and other snack items. Trans fats are also
common ingredients in deep fried foods, like French fries. The more you remove
these foods from your diet, the better off you’ll be. (Be sure to check out
the ratatouille recipe for a healthy vegetable dish
that has no saturated or trans fats.)
- Exercise regularly. Exercise can also help you control your blood sugar,
because your body uses glucose to help your muscles move. Depending on the
type of diabetes you have, regular exercise can reduce your daily insulin
injection requirement, or it can help your body better regulate the use of its
own insulin. In addition, exercise promotes weight loss, improves muscle tone,
keeps your heart and lungs healthy and active and lowers blood cholesterol and
triglyceride levels. If you are overweight, or don’t exercise regularly, it’s
best to check with your healthcare provider before starting an exercise
regimen. Keep in mind, the hardest part is getting started. Once you make
exercise part of your routine, you will notice progress and have more energy
in a very short time!
- Take any medication your doctor has prescribed for you. Now that the NHLBI
has revised its cholesterol guidelines, more people are candidates for
cholesterol-lowering medications. Statins are the drug of choice for this.
(Remember that for a small number of people, muscle pain can be a side effect
of statins. Be sure to tell your doctor if you experience this.)
National Institute of Diabetes and Digestive and Kidney Disorders;
National Heart, Lung, and Blood Disorders.